Trick or Mnemonic to remember AJCC Breast Cancer Staging

From above, we know that T4 is either Stage III – b or c (cannot be “a” and cannot be “c”)

T4N2 = Stage IIIb

Remaining T 1-3 is Stage IIIa

T 1,2,3 N2 = Stage IIIa

With remaining T 1-3 and N0-1, add them up:

Add upto make 1: Stage I (T1No)

Add upto make 2: Stage IIa (T1N1 or T2N0)

Add upto make 3: Stage IIb (T3N0 or T2N1)

Add upto make 4: Stage IIIa (T3N1)

Nottingham Prognostic Index (NPI) Score

NPI score is an indicator of breast cancer outcome based on:

1. Nodal score (N)

No positive nodes = 1

1-3 positive nodes = 2

≥4 positive nodes = 3

2. Modified Bloom and Richardson Grade (G): 1-3

3. Tumor invasive size in cm (S)

NPI Score = (0.2 x Invasive Size) + Grade + Nodes

Interpretation:

NPI Score

Prognostic Group

≤2.4

Excellent Prognostic Group (EPG)

2.4 – 3.4

Good Prognostic Group (GPG)

3.4 – 4.4

Moderate Prognostic Group 1 (MPG1)

4.4 – 5.4

Moderate Prognostic Group 2 (MPG2)

>5.4

Poor Prognostic Group (PPG)

Nottingham Prognostic Index Plus (NPI+) Score

NPI+ works by using a panel of biomarkers to assess the biological behaviour of an individual’s tumour by measuring protein expression levels. Combined with a novel bioinformatic and expert system, it can then can sub-classify patients into one of seven clinically distinct biological classes. Importantly, this approach has the potential to predict both clinical outcomes and relevant therapeutic options in breast cancer more accurately than existing methods.1http://nuhrise.org/2010/11/nottingham-prognostic-index-plus-npi-a-ground-breaking-tool-for-breast-cancer/

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